skip to main content

Granulomatosis with polyangiitis — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateVasculitisGranulomatosis with polyangiitisSCE Rheumatology

A 24-year-old man has chronic sinusitis, otitis media, haemoptysis, cavitating pulmonary nodules, red cell casts and PR3-ANCA positivity. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: EGranulomatosis with polyangiitis

Granulomatosis with polyangiitis is the single best answer because ENT disease, cavitating lung nodules and glomerulonephritis with PR3-ANCA indicate GPA. The stem is testing diagnostic synthesis, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Migraine is less suitable because it fits a different clinical pattern or a different treatment threshold; Sarcoidosis, Aspirin monotherapy and Etanercept do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: BSR/EULAR vasculitis recommendations; NICE technology appraisals; BNF